Examination-re-evaluation-fee-refund-form.pdf
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To The Finance Officer, H.P. Technical University, Gandhi Chowk, Hamirpur (HP) 177001
Subject: Sir, 1. 2 3 4 5 6 7
Exam/Re-evaluation Fee Refund Form.
Kindly refund the fee deposited in HPTU as per particulars given below: Name of Candidate Email Address Mobile: Father’s Name Course/Branch/Semester Form No. Exam with Month/Year Mode of Payment Txn.No. Amount Date (Mention all transactions) Debit/Credit Card Net Banking Offline PNB Challan
8 9
Amount of Refund: Reasons for refund
Rs.
10 Particulars of Account Holder for refund: 1. Name 2. Name of Bank & its Branch 3. IFSC Code 4. Account No. 5. Mobile No. 6. Have you contacted your bank customer care for problem in online payment ?
YES
/
NO
Certified that : 1. I have not contacted the customer care of the Bank after my payment is deducted from my bank account. 2. I will refund the extra amount to HPTU received erroneously from HPTU Account, at a later date.
Dated:
Signature of Student: ………………………….. Name of Student: ……………..………………. Registration No :………………….…………… College: ………………………………… …………………………………
Terms & Conditions for refund: 1. Refund is payable to such students who are not able to generate exam form after making online payment and deposit extra fee through online/offline against the same form. 2. Refund form is submitted by the student himself within a period of two months after the last date of the filling the exam/re-evaluation form. 3. The refund will be made only after reconciliation with the Bank. 4. The HPTU reserves the right to hold the result of the student in case refund is already made by the Bank at its own.
Subject: Sir, 1. 2 3 4 5 6 7
Exam/Re-evaluation Fee Refund Form.
Kindly refund the fee deposited in HPTU as per particulars given below: Name of Candidate Email Address Mobile: Father’s Name Course/Branch/Semester Form No. Exam with Month/Year Mode of Payment Txn.No. Amount Date (Mention all transactions) Debit/Credit Card Net Banking Offline PNB Challan
8 9
Amount of Refund: Reasons for refund
Rs.
10 Particulars of Account Holder for refund: 1. Name 2. Name of Bank & its Branch 3. IFSC Code 4. Account No. 5. Mobile No. 6. Have you contacted your bank customer care for problem in online payment ?
YES
/
NO
Certified that : 1. I have not contacted the customer care of the Bank after my payment is deducted from my bank account. 2. I will refund the extra amount to HPTU received erroneously from HPTU Account, at a later date.
Dated:
Signature of Student: ………………………….. Name of Student: ……………..………………. Registration No :………………….…………… College: ………………………………… …………………………………
Terms & Conditions for refund: 1. Refund is payable to such students who are not able to generate exam form after making online payment and deposit extra fee through online/offline against the same form. 2. Refund form is submitted by the student himself within a period of two months after the last date of the filling the exam/re-evaluation form. 3. The refund will be made only after reconciliation with the Bank. 4. The HPTU reserves the right to hold the result of the student in case refund is already made by the Bank at its own.
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